EUGLOREH project
THE STATUS OF HEALTH IN THE EUROPEAN UNION:
TOWARDS A HEALTHIER EUROPE

FULL REPORT

PART II - HEALTH CONDITIONS

7. ACCIDENTS AND INJURIES AND RELATED TIME TRENDS: PREVALENCE, INCIDENCE AND MORTALITY

7.3. Data analysis and presentation

7.3.4. Unintentional injuries - overview by sector

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7.3.4. Unintentional injuries - overview by sector

 

Unintentional injuries can be assigned to three main sectors:

·          Transport / Traffic

·          Work place

·          Home, leisure and sports

 

For the area of home, leisure and sports the political administrative responsibility is not as clear as it is for the other two sectors as it is still distributed among several governmental units, e.g. health sector, consumer safety, social welfare, etc.). This makes is difficult to attribute competencies and requires comprehensive coordination.

 

Distinguished by sector, work place accidents account for 4% of unintentional fatalities, transport accidents for 33%, and almost two thirds of fatalities are attributed to the “residual category” of home, leisure and sports accidents. This categorisation is not completely clear-cut but provides a useful orientation for cross-sector injury prevention by linking the strong vertical sectors of work place and road safety with the horizontal WHO approach to injury prevention (Figure 7.6).

 

Figure 7.6. Unintentional fatal injuries by sector, EU27

 

While the magnitude of the injury epidemic is alarming, the location of the vast majority of injuries may cause even more concern. The reality is that EU citizens are more at risk of being injured, also fatally, either at home, at school, during leisure time and sports activities than in any other location.

 

Transport sector

 

Based on the WHO definition, a transport injury event is an incident involving a transport device and resulting in injury. The transport area can be further specified either by the vehicles used (train, cars, two-wheelers) or by the area (road, water, etc.) where the accident has occurred.

 

Road transport is one of the most complex and most dangerous systems people have to deal with on a daily basis. Almost 50 000 road fatalities (definition according to WHO, 2004) and 1.7 million injured road users according to police records are the recent toll of road traffic in the EU. Road fatalities in the EU27 range from 4 per 100 000 inhabitants in Malta to 22 in Lithuania which indicates the potential for further reduction of road traffic mortality in some Member States (Figure 7.7).

 

Figure 7.7. Road fatalities and injured road users

 

More than half of road fatalities are passengers or drivers of cars but vulnerable road (pedestrians, cyclists and motorcyclists) account for at least 40% of road fatalities (Figure 7.8).Even the high share of vulnerable road users in these absolute figures is likely to underestimate the real risk of pedestrian and two-wheeler traffic participation. The relationship between risk and exposure has recently been explored in the DG TREN SafetyNet project (http://www.erso.eu/safetynet/content/safetynet.htm).

 

Figure 7.8. Fatalities per road user type

 

More information about circumstances and external causes of road accidents for the identification and quantification of road safety problems throughout the European roads can be obtained from the European Road Accident Database (CARE) and the International Road Traffic and Accident Database (IRTAD) - only by members of these databases - and in the future also from the EU Injury Database (IDB).

 

According to an assessment made by the police, the majority of injured persons at road traffic accidents only sustain slight injuries (Figure 7.9).

 

Figure 7.9. Nonfatal road traffic accidents per age group and injury severity

 

Work place

 

According to data aggregated by EuroStat and the WHO, more than 6 000 work place fatalities are recorded per year in the EU27. They range from 0.3 per 100 000 inhabitants in the United Kingdom to 3.2 in Portugal. Also the rate of non-fatal work place accidents shows a significant variation between Member States due to differences in national definitions and registration practices (Figure 7.10).

 

Figure 7.10. Fatalities and injured due to work-related accidents

 

Half of all work place fatalities occur in two branches: the construction (30%) and the manufacturing branch (20%). These twoleadingbranches are followed by the transport sector (18% of all work place fatalities) which indicates the need for a close cooperation of work place and traffic safety institutions (Figure 7.11).

 

 

Figure 7.11. Fatalities at work by economic activity, EU15

 

More information about the socio-demography and circumstances of work place accidents can be found in the European statistics on accidents at work (ESAW) and the WHO Health for All database (HFA-DB). Within the framework of ESAW only harmonised data on accidents at work of EU15 was collected. The extension to the other Member States is still ongoing. Weaknesses of this system and problems with comparability of the national figures are described in Chapter 6.2. Figure 7.12. Non-fatal work place accidents by severity, EU15 + NO shows the severity of non-fatal work place accidents in terms of lost working days.

 

Figure 7.12. Non-fatal work place accidents by severity, EU15 + NO

 

Home and leisure

 

The identification of home and leisure accidents in the available injury registers is not without controversy as they do not represent a category of their own in ICD statistics. Their scope can be estimated by considering all unintentional fatalities that are neither traffic nor work place accidents.

 

Calculated in this way, the average rate of fatal home and leisure accidents in the EU27 is 22 per 100,000 residents and is more than twice as high as the mean rate of fatal road traffic accidents. In absolute terms every year more than 100 000 EU citizens die from home and leisure accidents and 32 million injured people need to be treated in hospital (Figure 7.13).

 

Figure 7.13. Fatalities and injured due to home and leisure accidents per country

 

These numbers make home and leisure the setting in which most injuries happen and for which capacities for prevention are least developed. Home and leisure accidents also comprise sport injuries that account for about 18% of this injury sector (Figure 7.14).

 

Figure 7.14. Non fatal (hospital treated patients) home and leisure accidents per activity at the time of injury

 

Injury surveillance in the home and leisure area is still neglected in most EU Member States which in turn hampers respective injury research. A prevention-oriented „all injurysurveillance system such as the EU Injury Database (IDB) is currently operated by only thirteen European countries. This is surprising as the establishment of specially designed injury surveillance systems is widely advocated as a prerequisite for the development and evaluation of injury prevention strategies. The IDB provides a variety of indicators on hospital treated injuries, on both inpatients and outpatients, and for the purpose of injury prevention in particular important circumstances such as activity at the time of injury, type of sports, injury mechanism, place of occurrence etc. (see also IDB” in Chapter 6.2).